Evidence map›Paper›PMID 27155885›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2016

Potential cost-effectiveness for using patient decision aids to guide osteoporosis treatment.

H Penton, M Hiligsmann, M Harrison, J-Y Reginster, A Boonen, N Bansback

Abstract read
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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

  1. A quasi-experimental study about shared decision-making and motivational interviewing on patients with a recent fracture attending Fracture Liaison Services.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024
    Article
  2. Cost-effectiveness of a multicomponent-adherence intervention in fracture liaison services.Expert review of pharmacoeconomics & outcomes research · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 4 countries.

H PentonSchool of Health and Related Research, University of Sheffield, Sheffield, UK.
M HiligsmannDepartment of Health Services Research, CAPHRI Research Institute, Maastricht University, Maastricht, The Netherlands.
M HarrisonFaculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada.
J-Y ReginsterDepartment of Public Health, Epidemiology, and Health Economics, University of Liège, Liège, Belgium.
A BoonenDepartment of Internal Medicine, CAPHRI Research Institute, Maastricht University, Maastricht, The Netherlands.
N BansbackCentre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada. nick.bansback@ubc.ca.
Maastricht University · NLUniversity of British Columbia · CACentre for Advancing Health Outcomes · CAUniversity of Liège · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

unlabelledWe use a model to predict whether using a patient decision aid in patients considering bisphosphonate therapy would be a good use of health resources. We found that if the decision aid improved adherence, and only marginally increased time physicians needed with their patients, then the decision-aid would be cost-effective.

introductionOral bisphosphonates have been shown to reduce the risk of osteoporotic fracture. Adherence is crucial but suboptimal. A recent study suggests that a patient decision aid, which facilitates shared decision-making, could be effective in increasing adherence to bisphosphonates. But decision aids come at a cost in terms of additional time spent with physicians. This study considers the emerging evidence on the role of patient decision aids in improving adherence to bisphosphonates and their potential costs to inform future decision-making and research priorities.

methodsWe estimate the hypothetical cost-effectiveness of a patient decision aid detailing the benefits and risks of bisphosphonates for osteoporotic patients, from a Canadian healthcare perspective. A previously developed and validated Markov microsimulation model was adapted to include use of a patient decision aid to support the decision of whether to initiate bisphosphonate therapy, and subsequent influence on adherence and future fractures. We considered 2014 costs and benefits in terms of quality-adjusted life-years (QALYs).

resultsA patient decision aid that could improve treatment initiation rates or persistence (adherence) by 20 %, or a linear combination of the two, in osteoporotic women aged 70+ over a 3-year treatment period was found to have an incremental cost-effectiveness ratio below $50,000/QALY.

conclusionsPatient decision aids have the potential to be cost-effective in osteoporosis so long as they increase adherence under certain conditions. Funding further research on the long-term effectiveness and costs of a patient decision aid which outlines all treatment options for osteoporosis patients is justified.

Indexed as

Cost-Benefit AnalysisDecision Support TechniquesAgedAged, 80 and overCanadaDiphosphonatesFemaleHumansMaleMarkov ChainsMedication AdherenceMiddle AgedOsteoporosisQuality-Adjusted Life YearsDiphosphonatesAdherenceBisphosphonatesCost-effectivenessOsteoporosisPatient decision aidShared decision-making

Identifiers

PMID27155885
OpenAlexW2346806743

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.